| NPI | 1356315097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: ME PT5724) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 2251S0007X Physical Therapist, Sports | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NC 8659) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ME AT810) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2021-07-26 |